Faculty Collaboration Database

Tissue harmonic imaging improves organ visualization in trauma ultrasound when compared with standard ultrasound mode. Acad Emerg Med 2002 Jan;9(1):48-53

Date

01/05/2002

Pubmed ID

11772669

DOI

10.1111/j.1553-2712.2002.tb01166.x

Scopus ID

2-s2.0-0036142258 (requires institutional sign-in at Scopus site)   29 Citations

Abstract

UNLABELLED: The focused abdominal sonography for trauma (FAST) examination is complicated by brightly lit trauma bays, limited time, and body habitus. Recently, new ultrasound (US) technology has become available that improves organ visualization in abdominal scans.

OBJECTIVE: The hypothesis was that a new US mode, tissue harmonic (TH) imaging, improves visualization of critical organ relationships in the FAST examination by making use of previously unused frequencies. The authors performed a blind, prospective observational study to compare the images obtained in typical FAST views with those obtained in standard US and TH modes.

METHODS: Blunt trauma patients presenting to a level I trauma center between April and September 2000 were enrolled on a convenience basis. Typical FAST views were obtained in standard and TH modes. The emergency ultrasonographer (EU) switched between modes for each view, optimizing the gain each time. Multiple digital still images were made with all indications of the mode used disguised. For each view on a patient, the best image in each mode was selected in a blinded fashion. Three experienced EUs, blinded to the mode used, rated each image pair for resolution, detail, and total image quality as previously defined on a ten-point Likert scale, 10 being the best for each category. Wilcoxon signed-ranks test, 95% confidence intervals (95% CIs), and interobserver correlation were calculated.

RESULTS: A total of 76 image groups (39 of Morison's pouch, 20 splenorenal, and 17 bladder) from 52 patients were rated. Tissue harmonics produced improved resolution, detail, and quality when compared with the standard US mode, with median scores of 6.7 vs. 6.0, 6.7 vs. 6.0, and 6.3 vs. 6.0, respectively. The differences of 0.7 (95% CI = 0.4 to 0.93), 0.7 (95% CI = 0.4 to 0.93), and 0.33 (95% CI = 0.17 to 0.67) were statistically significant, with p = 0.0001, 0.0001, and 0.0003, respectively. There was good interobserver agreement (kappa = 0.74; 95% CI = 0.68 to 0.79).

CONCLUSIONS: Tissue harmonics produced FAST images higher in detail, resolution, and total image quality than standard-mode US images.

Author List

Blaivas M, DeBehnke D, Sierzenski PR, Phelan MB

Author

Mary Beth Phelan MD, RDMS Professor in the Emergency Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Abdomen, Acute
Confidence Intervals
Emergency Service, Hospital
Emergency Treatment
Female
Humans
Image Enhancement
Injury Severity Score
Male
Observer Variation
Prospective Studies
Sensitivity and Specificity
Single-Blind Method
Statistics, Nonparametric
Trauma Severity Indices
Ultrasonography
Wounds, Nonpenetrating